• Title/Summary/Keyword: Procedure of botulinum toxin injection

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A Pilot Study to Evaluate the Efficacy and Safety of Treatment with Botulinum Toxin in Patients with Recalcitrant and Persistent Erythematotelangiectatic Rosacea

  • Park, Kui Young;Kwon, Hyun Jung;Kim, Jae Min;Jeong, Guk Jin;Kim, Beom Joon;Seo, Seong Jun;Kim, Myeong Nam
    • Annals of dermatology
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    • v.30 no.6
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    • pp.688-693
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    • 2018
  • Background: There are few pharmacologic options to reduce erythema and flushing in patients with recalcitrant erythematotelangiectatic rosacea (ETR). We previously reported two cases of refractory flushing and erythema of rosacea that were successfully treated with intradermal botulinum toxin injection, and additional research is needed to prove the efficacy and safety of this treatment. Objective: To report the efficacy and safety of botulinum toxin injection as an aid in persistent erythema of rosacea patients. Methods: A total of 20 Korean patients with recalcitrant ETR were enrolled to receive treatment by injection of botulinum toxin. Patients received one treatment of intradermal botulinum toxin injection and were assessed 1, 2, 4, and 8 weeks after treatment. The severity of erythema and telangiectasia was investigated by a non-treating physician, and the Erythema Index (EI) was assessed by mexameter at each visit. Patient satisfaction and any adverse events were also assessed at each visit. Results: 17 patients completed all follow-up visits and were included in the analysis. Intradermal injection of botulinum toxin significantly reduced erythema severity and EI in ETR patients. Patients reported a satisfaction score of $2.94{\pm}0.56$ at 8 weeks after treatment. Except for three patients who discontinued the study early due to inconvenience of facial muscle paralysis, 17 patients participating in the final analysis did not report side effects except injection pain at the time of the procedure. Conclusion: Intradermal injection of botulinum toxin can be used as an effective and relatively safe adjuvant agent for recalcitrant and persistent erythema of ETR patients.

The Effect of Botulinum Toxin Type A for the Vocal Fold Granuloma (Botulinum Toxin Type A (BOTOX$^{\circledR}$)를 이용한 성대 육아종의 치료효과)

  • 김정홍;김한수;남지인;장정현;김지훈;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.40-46
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    • 2003
  • Background and Objectives : The vocal fold granuloma has been associated with vocal abuse, gastroesophageal reflux, endotracheal intubation and habitual throat clearing etc.. Granuloma is benign growth of hypertrophic granulation tissue. It is usually located on the posterior third of vocal fold, in one or both vocal process of the arytenoid cartilage In spite of the voice therapy, steroid therapy, anti-reflex therapy and surgical procedure. The distinct advantage and uniform success rate of each methods have not been generally shown. Authors report that localized injection of botulinum toxin type A (BOTOX$^{\circledR}$) is the promising method both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates. Materials and Method : We carried out a retrospective study of 9 patients with the diagnosis of vocal fold granuloma on the videostroboscopic examination from Jan 2000 to Mar 2003. The botulinum toxin type A was injected into one or both thyroarytenoid muscle or lateral cricoarytenoid muscle under the electromyography. The average dosage ranges from 6U to 8U per injection. Results : Unilateral vocal fold granuloma in 7 patients had been resolved completely within 2-3 months after first injection : 5 patients received th\ulcorner GER medical therapy in addition to the Botulinum toxin injections, 2 patients was resolved completely who had shown recurrence after $CO_2$ laser vaporization. 2 patients who had shown recurrence after $1^st$ injection were also completely resolved within 6 months after further injections. Conclusion : We expect that localized injection of Botulinum toxin type A can provide an alternative treatment for the refractory cases to the traditional forms of therapy and avoid the recurrence in conjunction with proper medical and voice therapy against GER and vocal abuse.

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Comparison of Flexible Nasopharyngoscopy-Guided Injection With Telelaryngoscopy-Guided Injection of Botulinum Toxin on Spasmodic Dysphonia (보툴리눔독소를 이용한 연축성 발성장애의 치료에 있어 연성비인두경법과 Telelaryngoscope법의 비교)

  • 최홍식;서진원;문형진;이주환;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.2
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    • pp.199-203
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    • 1997
  • In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using a flexible nasopharyngoscope was conducted in 29 patients and using a telearyngoscope in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under flexible nasopharyngoscopic guidance with sclerosing needle or telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 60 patients, 59 patients were given the toxin successfully. Telephone interview were made at 2weeks and then at 4 weeks post injection. Among 29 patients using a flexible nasopharyngoscope, 75.8% and among 31 patients using a telelaryngoscope, 90.0% reported that the patients' symptom was improved. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade fir the patients using flexible nasopharyngoscope and telelaryngoscope was 1.6 and 2.1 respectively. And it was lowered to 0.7 and 1.1 respectively after the injection. The result was similar(p<0.05). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 44 and 40 respectively. And it was improved to 77.7 and 69.8 respectively after the injection. The result was similar(p<0.05). In conclusion, botulinum toxin injection using a flexible nasopharyngoscope is also an effective method for the treatment of adductor type spasmodic dysphonia as using a telelaryngoscope.

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Surface Mapping of Masseter for Botulinum Toxin Injection (교근에서 보툴리눔 독소 주사점의 표지화)

  • Kim, Jun Hyung;Lee, Min Jae;Kim, Hyun Ji;Son, Dae Gu;Han, Ki Hwan;Lee, So Young;Lim, Jung Guen;Choi, In Jang
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.311-313
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    • 2005
  • Generally, many Asian women tend to dislike the square jaw, as they believe it makes the face look wider, giving a stubborn and strong impression. Contouring of the mandible is therefore a relatively common aesthetic procedure among Asians. These days, the use of botulinum toxin for contouring of the lower face offer simple alternative to surgery. Motor point, which is the site over a muscle where its contraction may be elicited by a minimal intensity short duration electrical stimulus, is the optimal injection point of botulinum toxin. Study was undertaken to identify the location of motor point of the masseter muscle and the skin surface landmark. First, the thickest point of the masseter muscle was inspected through palpation and inspection by 3 different individual plastic surgeons and then compound muscle action potentials(CMAPs) of masseter muscle in 15 health volunteers were recorded using EMG. For the localization of the measured points, line between lateral canthus to the mandibular angle was used. Location of motor points were mapped to skin surface from lateral canthus in a percentage of the distance along the landmark line and in distance in millimeters. The clinical injection point was located at 71.69 percentile and 7.3 mm of the landmark line. The motor point test was located at 72.54 percentile and 7.1 mm of the landmark line. The depth of motor point was 16mm. There was no statistically significant difference between the clinical injection point and the motor point. We conclude that surface mapping of motor point of the masseter muscle would increase accessibility and accuracy in botulinum toxin injection for contouring of the lower face.

Clinical anatomic consideration of the superficial layer of the masseter muscle for botulinum toxin injection (보툴리눔 톡신 주사를 위한 깨물근 얕은층의 임상해부학적 고찰)

  • Lee, Hyung-Jin;Kim, Hee-Jin
    • The Journal of the Korean dental association
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    • v.55 no.5
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    • pp.365-369
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    • 2017
  • In clinical dentistry, botulinum toxin is generally used to treat the square jaw, bruxism, and temporomandibular joint diseases. Recently, this procedure has been expanded and applied for cosmetic purposes, and it is becoming a key task to be aware of the precise anatomical structure of the target muscles to be cautious during treatment and how to prevent side effects. Therefore, the purpose of this study is to observe the anatomical structure of the superficial layer of masseter muscle and to provide a most effective botulinum toxin injection method through clinical anatomical consideration. It was observed that the muscle belly of superficial part of the superficial layer was originated from the deep to the aponeurosis of masseter muscle and descend, then changed gradually into the tendon structure attaching to the inferior border of the mandible. In this study, we named this structure deep inferior tendon. This structure was observed in all specimens. We conclude that the use of superficial layer and deep layer injection should be considered to prevent paradoxical masseteric bulging in consideration of the deep inferior tendon of superficial part of superficial layer of masseter muscle.

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A Case of Mutational Falsetto with Marked Contraction of Suprahyoid Muscles Treated with Botulinum Toxin (설골상근의 과도수축을 동반한 변성발성장애환자에 대한 보툴리눔 독소 주입 치료 1례)

  • 최홍식;정유삼;김원석;표화영;이경아
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.1
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    • pp.65-68
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    • 1997
  • The mutational falsetto is failure to change from the higher pitched voice of preadolescence to the lower pitched voice of adolescence and adulthood. The one of characteristic findings is contraction of suprahyoid muscles. The large majority of young men with inappropriately high voice have excellent voice therapy prognosis. We have experienced one case of mutational falsetto treated with botulinum toxin injection on suprahyoid muscles. His suprahyoid muscles are contracted markedly simultaneously with each phonation. fundamental frequency$(F_0)$ of his vowel phonation was 332Hz. Extensive voice therapy including manual compression of thyroid notch was ineffective. Forty units of Botox$^{\circledR}$ was injected under the EMG-guidance(20U bilaterally). At seven days post-injection, his voice changed lower than before and at 40 days after procedure, his $F_0$ was 126Hz.

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Page kidney after botulinum toxin injection during chiropractic care

  • Park, Han Min;Choi, Chung Jo;Kim, Jin Hee;Kim, Ja Kyung;Kim, Bum Jun;Seo, Jae Yong;Jeong, Yong Seol;Kim, Jwa-Kyung;Kim, Sung Gyun
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.143-145
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    • 2015
  • Page kidney refers to the phenomenon of hypertension secondary to long-standing compression of renal parenchyma caused by renal subcapsular collection. The most common cause of renal subcapsular collection is a hematoma which usually occurs after a history of blunt trauma. A 42-year-old female patient who received botulinum toxin injection in her back during chiropractic care was admitted to the emergency room with sudden bilateral flank pain and hypertension. The computed tomography (CT) images demonstrated the presence of bilateral subcapsular renal hematoma. The patient was treated conservatively and recovered well. The follow up CT images showed markedly resolved bilateral hematoma.

A Case of Thyroarytenoid Myectomy with Selective Recurrent Laryngeal Nerve Section in Intractable Spasmodic Dysphonia: A Long-Term Follow-Up (난치성 연축성 발성장애 환자에서 갑상피열근 절제술 및 선택적 반회후두신경 절제술 1예: 장기 추적 관찰)

  • Lee, Yun Ji;An, You Young;Park, Ki Nam;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.35-38
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    • 2020
  • Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

The Comparison of Long-term Effect of Botox® injection on Lower Face Contouring after Single injection and Long-term Repeated injections by Standardized Photograph Analysis (Botox®를 이용한 하안면윤곽술에서 단일시술과 장기간 반복시술의 효과 지속 기간의 비교: 표준화된 사진 계측을 이용한 분석)

  • Park, Mee Young;Ahn, Ki Young
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.654-659
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    • 2009
  • Purpose: A botulinum toxin type A (BoNT - A) injection has been used as a noninvasive management for lower face contouring since 2000. The aim of this study was to compare reduction rate of lower face width for a longtime according to repeated Botox$^{(R)}$ injections on masseter muscles for lower face contouring procedure. Methods: Forty - five patients were analyzed for single session of Botox$^{(R)}$ injection and 13 patients were evaluated for repeated Botox$^{(R)}$ injections for over two years. Single injection group was tracked regular intervals at 1, 3, 6, 10, 12 months after injection, and repeated injection group was measured at every injection time. Twenty - five to thirty units of Botox$^{(R)}$ was injected into each masseteric muscle at five to six points at the prominent portions of the mandibular angle. Standardized frontal view of digital photographs were analyzed by Adobe Photoshop$^{(R)}$ (version CS3) to measure an reduction rate of lower face width. Results: Reduction rate was 3.7%, 6.9%, 6.2%, 4%, 4% at 1, 3, 6, 10, 12 months post injection each other in single injection group. However, more than 8% reduction rate was found in repeated injection group persistently for more than two years. Conclusion: This study shows that effective duration of Botox$^{(R)}$ injection for lower face contouring is expected to continue over one year clinically. Moreover, repeated injections maintained lower reduction rate consistently for a long time. Therefore, repeated injections on masseter muscles at regular intervals are most effective procedure for lower face contouring.